M. Brian Fennerty, MD, is the editor of Journal Watch Gastroenterology and Professor of Medicine and Section Chief of Gastroenterology in the Department of Internal Medicine at Oregon Health & Science University.
Learn more about Gut Check on Gastroenterology.
(3 votes, average: 4.33 out of 5)Many, if not most, colonoscopists are now convinced that using water infusion during scope insertion leads to less patient discomfort and lower sedation needs. What is often used in this situation is water that has been warmed under the assumption that warm is better (i.e., causing less spasm). However, using warm water out of the [...]
(1 votes, average: 1.00 out of 5)I have observed extreme variation in how my colleagues manage GI foreign-body retrieval from the stomach. Some always use general anesthesia and endotracheal intubation; others (myself included) use conscious sedation. Some use an overtube to withdraw the object into if possible; others simply pull it up to the endoscope and use the endoscope to guide [...]
(7 votes, average: 4.14 out of 5)Some of my patients who have undergone successful ablation therapy for Barrett’s esophagus ask a really good question: If I haven’t had Barrett’s for years, why do I need to keep having endoscopies?” I admit, I do not have a uniform answer for that, nor do GI society guidelines. I would say that for patients [...]
(6 votes, average: 4.33 out of 5)Consider this: The American Society for Gastrointestinal Endoscopy requires physicians to perform at least 200 colonoscopies before it will assess their competency (much less grant them privileges), and most fellows complete at least 500 during their 3-year training programs. However, the American Board of Surgery now “mandates” that surgical residents need to perform only 50 [...]
(No Ratings Yet)Ambulatory endoscopy centers (AECs) have proven so successful in providing convenient, efficient, low-cost, high-quality endoscopy services to outpatients that they are now ubiquitous around the country. Given this success, you might assume that payers would steer business their way. However, that’s not the case with the Centers for Medicare & Medicaid Services (CMS). In fact, [...]
(No Ratings Yet)Last week I heard one of our really talented GI fellows talking with a patient before her open access colonoscopy, and she told the patient that this test prevents colon cancer. I was somewhat surprised at the definitive implication of that statement and later asked her how much protection from colon cancer does colonoscopy screening provide? What [...]
(No Ratings Yet)What does it mean to be a gastroenterologist in 2008? Is our field moving in the right direction? I suspect that most gastroenterologists were and are attracted to the specialty because it offered the opportunity to deal with multiple organs and diseases. My generation of gastroenterologists came of age along with the exciting and emerging ability to [...]
